IMPLANTS DELIVERING BISPHOSPHONATE LOCALLY INCREASE PERIPROSTHETIC BONE DENSITY IN AN OSTEOPOROTIC SHEEP MODEL. A PILOT STUDY
IMPLANTS DELIVERING BISPHOSPHONATE LOCALLY INCREASE PERIPROSTHETIC BONE DENSITY IN AN OSTEOPOROTIC SHEEP MODEL. A PILOT STUDY
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DOI：
10.22203/ecm.v016a02
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发表时间：
2008-07-01
影响因子：
3.1
通讯作者：
Pioletti, D. P.
中科院分区：
文献类型：
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作者：
Stadelmann, V. A.;Gauthier, O.;Pioletti, D. P.
如何在骨质疏松较弱的骨质中获得足够的骨科种植固定是临床上的一大挑战。当种植体初期固定不良时，骨-种植体界面会发生微动，激活破骨细胞，导致种植体松动。双膦酸盐可以用来防止破骨反应，但当全身给药时，其生物利用度低，药物到达假体周围骨所需的时间可能是一个限制因素。最近的数据表明，从植入物表面局部输送双膦酸盐可能是一个有趣的解决方案。局部注射双膦酸盐可增加假体周围的骨密度，从而导致更强的种植体固定，如大鼠种植体拔出力的增加所证明的那样。本研究的目的是在一个骨质疏松的绵羊模型上验证局部双磷酸盐给药对假体周围骨重建的积极作用。将4枚包被唑来膦酸盐膜的种植体和2枚对照种植体植入去卵巢绵羊股骨髁部，共4周。与对照组相比，唑来膦酸盐组种植体表面的骨量增加了50%。在距植入物表面400微米的范围内，这种影响是显著的。目前的结果与在骨质疏松大鼠模型中观察到的结果相似，这表明从种植体局部释放唑来膦酸盐以增加种植体固定的概念不是物种特有的。这项试验研究的结果支持了局部唑来膦酸盐可以增加种植体在软骨中的固定的说法。
It is a clinical challenge to obtain a sufficient orthopaedic implant fixation in weak osteoporotic bone. When the primary implant fixation is poor, micromotions occur at the bone-implant interface, activating osteoclasts, which leads to implant loosening. Bisphosphonate can be used to prevent the osteoclastic response, but when administered systemically its bioavailability is low and the time it takes for the drug to reach the periprosthetic bone may be a limiting factor. Recent data has shown that delivering bisphosphonate locally from the implant surface could be an interesting solution. Local bisphosphonate delivery increased periprosthetic bone density, which leads to a stronger implant fixation, as demonstrated in rats by the increased implant pullout force. The aim of the present study was to verify the positive effect on periprosthetic bone remodelling of local bisphosphonate delivery in an osteoporotic sheep model. Four implants coated with zoledronate and two control implants were inserted in the femoral condyle of ovariectomized sheep for 4 weeks. The bone at the implant surface was 50% higher in the zoledronate-group compared to control group. This effect was significant up to a distance of 400 mu m from the implant surface. The presented results are similar to what was observed in the osteoporotic rat model, which suggest that the concept of releasing zoledronate locally from the implant to increase the implant fixation is not species specific. The results of this trial study support the claim that local zoledronate could increase the fixation of an implant in weak bone.